Focus on Health Care: American Recovery and Reinvestment Act of 2009

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On February 13, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 ("Act").

March 16, 2009

On February 13, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 ("Act"). President Obama signed the Act into law on February 17, 2009. The Act included various provisions impacting healthcare. The most notable is the incentive for eligible health care professionals to deploy and use certified electronic health record (EHR) technology.

In general, Medicare will provide an additional reimbursement for eligible health care professionals that implement EHR technology. The reimbursement methodology is based on a percentage of charges billed to Medicare by an eligible health care professional during the incentives years beginning in 2011 through 2014. The amount of the additional first year reimbursement is limited to $18,000 if EHR technology is implemented in 2011 or 2012, $15,000 if implemented in 2013 and $12,000 if implemented in 2014. For subsequent years, the reimbursement limits are as follows: Year 2- $12,000, Year 3 - $8,000, Years 4 - $4,000, and Year 5 - $2,000. If the first adopting year for deploying EHR technology is after 2014, no incentive payments will be made. For purposes of this EHR incentive, an eligible health care professional is defined as a physician, dentist, podiatrist, optometrist, and chiropractor. However, the aforementioned definition excludes these health care professionals if they are hospital based. Early adopters of EHR technology will qualify for the additional reimbursement beginning in 2011, as long as the technology satisfies the requirements as stated below.

To qualify for the incentives, the eligible health care professional must be a meaningful EHR user during the payment years. To satisfy this requirement, the following requirements must to be met:

The eligible health care professional must be using “certified” EHR technology in a meaningful way, which shall include electronic prescribing

The eligible health care professional must exchange electronic health information to improve the quality of health care, such as promoting care coordination

The eligible health care professional must submit information to Medicare on clinical quality measures and other measures as defined by Medicare.

Beginning in 2015, for those eligible health care professionals who are not “meaningful EHR” users, the Medicare fee schedule for services provided by eligible health care professional will be reduced by 1%. For 2016, the fee schedule payment is reduced by 2% and 2017 and thereafter the fee schedule payment is reduced by 3%. However, for 2018 and thereafter, if the Secretary concludes that the proportion of meaningful EHR users is less than 75 percent, the Secretary has the authority to further reduce the fee schedule to a maximum reduction of 5 percent.

Until further regulations are issued, it is unclear how, for example, a multi-physician practice would be reimbursed, whether the additional reimbursement would be in a lump-sum or installments payments, and what will constitute “certified” EHR technology. As more information becomes available, we will communicate this to you.

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